电视宫腔镜诊治91例绝经后子宫出血的效果分析

The Value of Hysteroscopy on Diagnosis Andtreatment of Postmenopausal Uterine Bleeding

目的 :回顾性分析电视宫腔镜对绝经后子宫出血的诊断和治疗效果。方法 :对 91例绝经后子宫出血患者行宫腔镜检查 ,其中 2 1例行电切术或病灶摘除术 ,病变组织送病理。结果 :绝经后出血的病因依次为粘膜下肌瘤、子宫内膜炎、子宫内膜息肉、子宫内膜单纯增生、萎缩性子宫内膜、子宫内膜癌等 ,宫腔镜诊断与病理诊断符合率依次为 :95 .2 %、10 0 %、88.9%、10 0 %、90 %、80 %。宫腔镜治疗宫腔良性病变所致子宫出血无一例复发。结论 :宫腔镜诊断绝经后子宫出血 ,优于诊断性刮宫 ;部分患者可同时行病灶摘除或电切术 ,减少了开腹手术对患者的创伤。

Objective:To analyses respectively the value of hysteroscopy for diagnosis and therapeutics for postmenopausal uterine bleeding.Methods:91 cases of postmenopausal bleeding were examined by hysteroscope.Among them,21 patients underwent electroresection or fociextirpation.Another 36 patients received trans-abdominal operation for myomectomy or hysterectomy as larger diameter of myoma(>5 cm),or endometrial carcinoma,or need to have a hysterectomy.Results:Etiology to causing postmenopausal uterine bleeding included submucosa myoma,endometritis,endometrial polyps,simple endometrial hyperplasia,atrophica endometrium,and endometrial carcinoma.The diagnostic coincident rate of hysteroscopy with pathological examination was 90%,100%,88.9%,100%,90%,and 80%,separatively.None patients with benign lesion of uterine cavity relapsed after treated by hysteroscope.Conclusions:Hysteroscopy is a better way for diagnosis of postmenopausal uterine bleeding,and meanwhile,some patients can avoid trans-abdominal operation,replaced by electroresection or foceextirpation.